Holly Ann Mixon, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S1189 Issued in MS

Practice address

4214 Bienville Blvd
Ocean Springs, MS 39564-5975

Phone

(228) 218-3362

Fax

(228) 872-9370

NPI assigned

Apr 23, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coastal Speech, Language, and Literacy, LLC

  • Hearing and Speech Clinic/Center
  • Ocean Springs, MS
  • NPI 1487338455
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1770701641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20250 WHITE RD",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656430",
            "telephone_number": "228-218-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4214 BIENVILLE BLVD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395645975",
            "telephone_number": "228-218-3362",
            "fax_number": "228-872-9370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20250 White Road",
            "address_purpose": "LOCATION",
            "city": "Vancleave",
            "state": "MS",
            "postal_code": "395656430",
            "country_code": "US",
            "telephone_number": "228-218-3362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIXON",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MS CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S1189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200002991",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "hmixon@coastalspeechllc.com",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20250 White Road",
            "city": "Vancleave",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395656430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mississippi State Department of Health
• Dana Suzanne Mitchell, M.S. CCC-SLP
• Jonathan Mitchell, PT
• Navasia Mitchell
• Patrick Jay Mitchell, OTR/L
• Arianna Mariam Mohiuddin, MD
• Karina Elaine Moore-Massey
• William Fox Moore, M.D.
• Zachary Moorer, PT
• Daniel Scott Morgan

• All providers in Ocean Springs, MS
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.